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Campaigners regroup after court set-back0 29/09/2016

Posted on 4 October, 2016 at 20:00

Campaigners regroup after court set-back 29/09/2016


The Justice for Health group is to take a "short break" after its unsuccessful legal bid to overturn the junior doctors' contract, it announced last night.


The group claimed a moral victory after the judge in the judicial review ruled that Health Secretary Jeremy Hunt did not impose the contract.


The judge said individual NHS Employers were free to make their own contracts with doctors.


Justice for Health says it will now explore new legal challenges and campaigns it could support for NHS staff and patients.


The group raised some £300,000 towards the case. Nearly half of that has been set aside to cover claims for costs from the government.


A statement from the group, Dr Ben White, Dr Nadia Masood, Dr Francesca Silman, Dr Marie-Estella McVeigh and Dr Amar Mashru, said: "Whilst we hoped for the top result, we have met our initial goal to extract clarity from the SoS and will now move on.


"We resolve to help the BMA to exert legal pressure in any way possible to combat the exploitation of NHS staff and annihilation of good quality patient care we have witnessed at the hands of this Health Secretary."


In the judgement Mr Justice Green said Mr Hunt had not sought to compel employers to introduce the new contract.


He said that "in principle" employers could negotiate different terms with employees.


He added that Mr Hunt could compel the use of the new contract to "achieve a consistent and uniform introduction of terms" across the NHS.


The judge said the hearing showed that Mr Hunt considered "the scope for individual negotiation may be limited because he has achieved consensus with the employers that the proposed new terms and conditions represent a fair and workable basis upon which to proceed to introduce a consistent, nationwide contract."


The ruling could lead to a focus on Health Education England, which has backed the new contract by warning employers that support for training could be at risk if they do not implement it.


Pressure group, the Junior Doctors Alliance, suggested the HEE could be a target, warning that legal action could be difficult.


Among other reactions, Dr Ellen McCourt, chair of the British Medical Association's junior doctors' committee, said the decision was not a victory for the government.


She warned: “Faced with a demotivated and frustrated workforce, the government must prioritise rebuilding the trust that has been lost with a generation of junior doctors – the GPs and hospital doctors of the future. As a first step towards this, it must address junior doctors’ continuing concerns with the contract before it comes into effect.


“With the NHS facing unprecedented pressure, it is critical to focus on how to assure its long-term future. Junior doctors are central to this. If even a small number choose to vote with their feet, this future looks increasingly uncertain.”


Danny Mortimer, chief executive of NHS Employers, said: "The NHS is committed to a system of fair national contracts, including this one for doctors in training.


"Employers are also committed to working with doctors representatives to oversee the implementation of the contract both nationally and locally.”

"Heart2Heart" advises don't sign a bad contract.

Hunt launches plan to boost doctor numbers and stem exodus 04/10/2016

Posted on 4 October, 2016 at 4:30


New doctors will have to work for the NHS for four years or repay training costs, health secretary Jeremy Hunt is due to announce today.


He is also due to set out plans for a 25% increase in medical school places, starting in two years time.


The £100 million cost of the first two years of expansion will be partly funded by increased charges to overseas students taking medical courses.


The increase will mean an extra 1,500 places for medical students.


A government source said: “It’s people who are trained at the taxpayer’s expense and then very quickly move abroad – that’s what we are trying to disincentivise.


“It costs £200,000 to train every doctor, so we think it’s reasonable to expect that the NHS will benefit from that investment.”


Government sources say the scheme will be similar to those used by the armed forces


Mr Hunt will tell the Conservative Party conference in Birmingham that his plans will address doctor shortages and help the government to its target of increasing GP numbers - while replacing staff lost after Britain quits the EU.


He will say that his plans will make the NHS self-sufficient in doctors by 2025. Fighter pilots have to serve in the RAF for 12 years after completing training.


Over the weekend he claimed that many bright applicants were rejected by medical schools.


He will say: “Currently a quarter of our doctors come from overseas. They do a fantastic job and we have been clear that we want EU nationals who are already here to be able to stay post- Brexit.


“But is it right to import doctors from poorer countries that need them whilst turning away bright home graduates desperate to study medicine?"


British Medical Association chair Dr Mark Porter said the proposals could lead to "demotivated, burnt-out" doctors.


He said: "We know there are chronic staff shortages and rota gaps across the NHS, with major recruitment problems in areas such as emergency medicine and general practice.


"The government must tackle the root causes of this workforce crisis and the reasons why so many UK-trained doctors are considering leaving the NHS rather than forcing doctors to stay in the health service. Demotivated, burnt-out doctors who don’t want to be in their jobs, will not be good for patients.”


But NHS Employers chief executive Danny Mortimer said: “Employers will welcome this significant investment to boost the number of training places for doctors. This should help address the challenges we face in filling rotas in many areas and support the longer term transformation of our services."


Comments on Doctors Net

Posted by bridgeth >> 04/10/2016 06:43

Re: Hunt launches plan to boost doctor numbers and stem exodus


Well, lets go the whole hog. Workforce trapped for 4 yrs, pay minimum wage, or even get them to pay, they might (in post brexit world where ewtd directive repealed) be working 60hours a week and every weelend, but hey, its a training post, they should pay for the priveledge. My guess also the 'new'. medical schools will be state funded but run for profit by organisations like Virgin. The trusts however will have to teach the students, for free as their funding will be at risk if they dont.


Posted by DanMoore >> 04/10/2016 06:57

Re: Hunt launches plan to boost doctor numbers and stem exodus


Indentured servitude. Charming.


Posted by docjonty >> 04/10/2016 07:00

Re: Hunt launches plan to boost doctor numbers and stem exodus


Please tell bright kids to do something else instead of medicine.


Posted by wchellam >> 04/10/2016 07:01

RE:Hunt launches plan to boost doctor numbers and stem exodus


You would have to be ........insane to even consider medicine as a university subject right now:


So, you do your univeristy degree, presumably after signing a contract saying you agree to work for the NHS for 4 years or "face the consequences"


There is no guarantee that the number of jobs will be increased by 1500 per year, and the notion that they ever will be seems utterly ridiculous given the current drive to run the NHS into the ground and the current state of finances for most trusts.


There is no guarantee of what your pay or conditions will look like, since the SoS has pretty much proven that they can be changed unilaterally at the drop of a hat, and, given that there's likely to be vastly more doctors than jobs, would be easy to do.


So, where's the upside? 


Posted by keithseymour >> 04/10/2016 07:02

RE:Hunt launches plan to boost doctor numbers and stem exodus


Also looking at the other end closely, DoH and minister are apparently looking for ways to stem existing pension payments which are seen as too generous, and being taken too early for non-health related reasons. Pensioners may be recalled if under existing retirement age and/or face cancellation of CEA payments after 3 years payments to bring them in line with existing rules for working doctors.


"Heart2Heart" Doctor asks for your comments

Deadlock over Junior Doctor strike plans

Posted on 7 September, 2016 at 10:30

Doctors Net post 06/09/2016


The BMA faced fresh calls today to abandon its planned programme of five-day strikes after it called off next week's action. The planned five-day strike was abandoned after the BMA bowed to concerns that hospitals did not have enough time to put contingency plans in place. It emerged that the General Medical Council had threatened to hold striking doctors responsible for safety incidents linked to ineffective contingency plans.



The GMC had earlier issued a strong statement raising concerns about the strikes. Chairman Professor Terence Stephenson said: "We do not believe that the scale of action planned at such short notice can be justified. We are now calling on every doctor in training to pause and consider the implications for patients." Health Education England also warned that the extensive strikes could affect training and recruitment timetables. It said a significant number of training events would have to be rearranged - and that the process of national recruitment would have to be rescheduled. There was little sign of the government agreeing to fresh talks on the dispute contract or to withdrawing its imposition.



The BMA said it planned to continue with planned five-day strikes in October, November and December. Health secretary Jeremy Hunt told MPs that the NHS would "work round the clock" to make preparations for strikes. He said the government would be pressing on with its seven-day working plans - aimed at improving emergency cover - and funding it from the £10 billion increase in spending due to the service.



Mr Hunt claimed there was "good progress" recently in talks about non-contractual issues. Challenged by the new MP Dr Roseena Allin-Khan, he claimed that calling the new contract an imposition was a "mischaracterisation." He said: "The contract was not only agreed, but recommended and supported by the leaders of the BMA. That is why it is so incomprehensible that those same leaders—the people who represent her and her profession—have now called the most extreme strike in NHS history."



Dr Allin-Khan said: "This is not the first time I have stood before the Secretary of State to say that I worry that the imposition of the contract does not put patient safety first. The Government can train all the extra doctors they want, but current junior doctors are leaving. The risk of having a contract imposed on them is causing them to move further afield to places such as Australia."



Last night Stephen Dalton, chief executive of the NHS Confederation, said: "Many appointments and operations have already been cancelled in preparation for the first of the four proposed walkouts. We urge all parties to continue talking to find a resolution before further industrial action takes place.”



The Patients Association called for talks. Chief executive Katherine Murphy said: "It is vital that there is a coherent plan with a satisfactory resolution for all parties, and the only way this can be achieved is if the two parties show willingness to resume discussion.”



BMA junior doctor committee chair Dr Ellen McCourt said last night: “Future action is still avoidable. The BMA has repeatedly said it will call off further action if the government puts a halt to plans to force junior doctors to work under a contract they have rejected because they don’t believe it is good for the future of patient care or the profession.



Posted by mdunn 06/09/2016 21:36 RE:Deadlock over autumn strike plans


You've got to look beyond your own past experience in the NHS, and try to understand why there was a huge rejection of the proposed (imposed) JD contract


There wasn't a huge rejection. A minority of juniors rejected it (68% of those entitled voted of whom 58%- about 40% of those entitled- voted against it and 42% voted for it). It was certainly rejected but not a huge rejection. It does put the BMA in a difficult position regarding strikes. A poorly supported strike would be a problem and it may well be that those who voted to accept the contract or for whatever reason did not vote would be fairly unlikely to strike along with those opposed to it enough to vote against it but not opposed strongly enough to strike. Add to that the concerns about striking at short notice which would always put some people off and I can see that calling off the first strike is a reasonable tactic.



Posted by shaumik 06/09/2016 21:46 Re: Deadlock over autumn strike plans


more of a mandate than brexit though...

Posted by andrewwest 06/09/2016 21:55 Re: Deadlock over autumn strike plans


The juniors are in a mess but they have only two options, continue the fight or roll over and let Jeremy Hunt's jack boots walk all over them. The choice is theirs. To any Consultant who criticises the Juniors I have this to say. After Jeremy Hunt has defeated the juniors he will come after you. Most likely the issue will be 7 day contracts. What are you going to do? Roll over and submit? Don't expect any support from the juniors after you have given them none.




Posted by Heart2Heart 06/09/2016 22:22 Re: Deadlock over autumn strike plans

Not easy; dont' strike or strike is 50:50 outcome now, due to government outwitting the BMA's 'amateur' strategists. Simple solution if willing to act en mass, don't sign any contract you don't agree with and tell trusts to continue old contract, or offer to work as a locum until real talks resume and HMG publically accept the 7-day argument for new junior contracts is false and lost.

lure risk linked to hospital admissions 30/08/2016

Posted on 30 August, 2016 at 5:40

 Heart failure risk linked to hospital admissions

Every time a patient with heart failure is admitted to an NHS hospital it increases the risk of their dying by 2%, according to a major UK study reported to a conference. Researchers said patients with a history of four or more admissions faced a 20% increased mortality risk. The findings came from an analysis conducted over 15 years of some 450,000 patients in Birmingham, UK. They have been reported to the conference of the European Society of Cardiology in Rome, Italy.

Researcher Dr Paul Carter said: “We need to diagnose heart failure patients efficiently and ensure that they are taking appropriate heart failure medications prior to discharge from hospital so that we minimise the chances of readmission as much as possible. "At the moment, there is significant variation in how well this is done across hospitals in spite of numerous clinical guidelines.”

Fellow researcher Dr Rahul Potluri said: “We have a triple whammy because heart failure is increasing, hospitalisation is increasing and this study shows that the risk of heart failure patients dying with each admission is higher by 2%. “The findings reflect the fact that heart failure is a progressive disease and should be a challenge to physicians to improve care even more.” He added: “Every effort should be made to start and/or optimise heart failure medications before patients leave hospital and ensure other interventions such as multidisciplinary community support are available for heart failure patients to reduce the risk of admission to hospital.”

Heart2Heart Doctor says:

I have experience with Home telemedicine using using my [email protected] service to enable early hospital dicharge and titration of heart failure medications.

Juniors urged to delay contract signing

Posted on 26 August, 2016 at 14:05

"Heart2Heart" Doctor: Posted on 03 August 2016 12:12

Junior doctors starting work today have been encouraged to take advice before signing contracts.



The advice comes from the British Medical Association and the campaign group Justice for Health. Under the government's plan to impose junior contracts, the first doctors are not set to get the new contracts until October. But there has been concern that some NHS trusts may seek to avoid mid-year signing sessions by getting new employees to sign the new contracts. The BMA has told doctors they are under "no obligation" to sign contracts on the day they start work. It has offered to check contracts - and has encouraged doctors to check the pay scale on which they are being placed. A circular from Justice for Health says "It is not a good idea to sign something you don't understand."


It warns doctors not to attempt to reach a conclusion on contracts on the day the day they start work. It says doctors should send their contracts to the BMA for analysis. The group warns: "Not signing the contract doesn't make it unenforceable."



Comments posted on Doctors.net


Posted by M P Mayfield 03/08/2016 06:43 Re: Juniors urged to delay contract signingDon't agree to something you don't want to do. The work needs to be done, but don't compromise your integrity. Make them negotiate.


Posted by David Fleming 03/08/2016 06:25 RE:Juniors urged to delay contract signingA pathetic response from the would be boxing banners. Df


Posted by Keith Seymour 03/08/2016 07:00 RE:Juniors urged to delay contract signingBetter still, write your own terms sign it and send it in for HR to sign. Contract imposition.


Posted by Skinner 03/08/2016 07:03 RE:Juniors urged to delay contract signingNot signing isn't worth the paper it isn't written on. Starting work has the same legal effect provided the terms of the contract offered are known. The BMA should know better, I've been provocatively defending the BMA, but it only goes so far. Another bit of clownery.


Posted by M Lewis 03/08/2016 07:06 RE:Juniors urged to delay contract signingWorking a contract is the same as signing it. You have to actively object to specific clauses rather than just "not signing". Puzzled by this. Hard to escape the impression it's all just fizzling out really.


Posted by Pixie 817 RE:Juniors urged to delay contract signingTo my junior fellows.. There is no obligation for you to start work in the NHS after graduation. There are many, many other options open to you. Starting work is paramount to accepting the contract, even without signing a physical one (unlike any other sector in the world, ours is the only one where you don't get to see or sign your contract until a few months into the job). If you object to the terms and conditions, do not start today. My advice is only start if it is the only thing in the world you feel you can and must do. This job of ours is a calling. If you feel the call is weak, leave now. Good luck.


Posted by Mike Farrell 03/08/2016 07:58 RE:Juniors urged to delay contract signing "Starting work has the same legal effect provided the terms of the contract offered are known" Not true You can decline to sign the contract , make a counter proposal and work "under dispute" seeing a few of the punters for a limited amount of time pending the other side considering your counter proposal. You can then walk away at a time determined by you (e.g. 1 week ) rather than being bound by the imposed contract normal notice period. The other side could of course decline this state of affairs and prevent you starting work on their premises. Seems unlikely .. Mike

Posted by J M C Glew 03/08/2016 08:10RE:Juniors urged to delay contract signing I never had a contract on the first day - until my GP reg year! Starting work is scary enough - imagine being a F1 and told you MUST sign this right now or lose your job - how many of us would be ready to refuse. We are letting down our next generation.


Heart2Heart Dr warns lack of whistleblowing protection for 54000 juniors.


See https://twitter.com/drcmday" target="_blank">Dr. C. M Day on twitter